Chronic disease costs the Australian community $27 billion a year and accounts for more than a third (36 per cent) of our national health budget. This cost to the health system is expected to grow as Australia’s population increases and ages.

It is common sense – prevention is better than the cure, right? So if it is so obvious, why do Australia’s health priorities continue to focus on treating illness rather than preventing it?

The cause of a chronic disease has many factors, and extends well beyond individual behaviours to include external factors such as the environment and the socio-economic characteristics of the communities in which people live.

Related Article

The journey to chronic disease starts in utero, with factors such as low birth weight, and lasts a lifetime. In the earlier stages, chronic disease is often silent, progressing incipiently until it reveals itself, by which time it is too late and the damage has been done.

The progressive nature of the disease may take many decades to evolve. A prime example of this is kidney disease, in which you can lose up to 90 per cent of your kidney function before you notice any symptoms.

Many chronic conditions share common risk factors, such as excess body weight, tobacco smoking, excessive alcohol consumption and insufficient physical activity - all of which can be modified through lifestyle changes.

However, modifying human behaviour is challenging and often unpopular. Prevention is often viewed as "the fun police". It can also be commercially damaging, impacting the revenue of food and drink manufacturers and tobacco companies.

Outcomes of health prevention interventions are often invisible - you are measuring the absence of disease. The presence of a disease is easier to comprehend than its absence. It is very easy to see the tangible benefit of, for example, an appendectomy for appendicitis. It is harder to appreciate the fact that you didn’t get chronic kidney disease because you had a healthy and balanced diet, took regular exercise and didn’t smoke.

At a very basic level, chronic disease prevention does not fit nicely into the three-year election cycle. The nature of chronic disease means that prevention initiatives take time to demonstrate results. There is no immediate "sugar hit", rather a sustained "low GI" benefit.

The continually revolving door of ministers means that they often only know what needs to be done towards the end of their term in office, by which time it is too late, and the baton has been passed to someone else to start all over again.

The multi-factorial nature of chronic disease means that it does not simply sit in the portfolio of the minister for health but sits to a greater or lesser extent in every ministerial portfolio from public transport and early childhood education, to agriculture and even racing (with the associations of alcohol and smoking).

With so many interested parties and competing priorities, it makes decision-making and action challenging at best, and impossible at worst. Perhaps what we need is a minister for prevention of chronic disease.

We need a sustained and integrated multi-sectorial approach that is delivered on many fronts including regulation, fiscal policy, awareness, education and management programs. These must focus not only on the high-risk populations but right from early life and childhood.

We need to build on the evidence base for prevention and measure our progress. And, of course, there needs to be dedicated funding.

Victoria used to be a leader in prevention of chronic disease, we are now looking to other states for guidance. The Victorian election is looming and we are yet to see any of the parties produce a truly holistic, impactful, outcome-driven policy on prevention of chronic disease.

Dr Lisa Murphy is interim CEO of Kidney Health Australia and a member of the Victorian National Chronic Disease Prevention Alliance.